How long can you be able to read something or think thoroughly about a certain thing without getting distracted by another thing? Are you satisfied with the duration of this which you are able to devote to it? Is it time dependant or activity dependant? Does it evolve over the years to you?
These are questions about what is referred to as attentional control – that is, our ability to keep our attention and thinking narrowly focused on a task, object or idea over a time frame. Attention control might involve two different brain systems – one that tracks increases and maintains attention on relevant information, and a second set that inhibits the impulse to pay attention to irrelevant information (i.e., gaze aversion, a second activity, changing the subject and cognitive distraction). These two systems become better as we grow up, moving through childhood to young adulthood (and then decline again during middle to later adulthood -with some studies indicating that this decline in systems is the focus systems, rather than the suppression domains as well).
It appears that, attentional control skills play crucial roles to our learning and problem solving skills. Indeed, it is not unheard of that certain psychologists have theorised that one of the reasons that cognitive skills have such a tendency to cluster among humans is because, through it, attentional control is what supports most, and perhaps nearly all, such skills. In other words, as long as we are able to focus our attention satisfactorily and over satisfactory duration, we can succeed at most things!
The direct antithesis of a good attentional control is called inattention and distractibility: in other words when our thoughts and attention to a certain idea or task that we were concentrating on, are involuntary diverted to other issues. Problems with the inattention and distractibility cause forgetfulness, slowing of work pace, lack of ability to organise or organise their time, inability to concentrate in conversations, forgetting what has been said or told to do, difficulties getting concentration during school/homework activities and many more problems brought about by inability to focus on anything.
Inattention and distractibility issues present challenges to all of us (children, young and adults) mainly when we are fatigued, bored, in pain and when we find ourselves in an environment that has something more interesting to capture our attention. Nonetheless, there are people who have more severe problems than others. Roughly one-fifth of children and adolescents have at least moderate problems in the area of inattention and distractibility, and 4-5 percent have severe problems.
Severely distracted and attentive individuals may be labeled with a psychological disorder -Attention Deficit Hyperactivity Disorder (ADHD). In the event that they have issues with inattention and distractibility exclusively, then it is referred to as Attention Deficit Hyperactivity Disorder Predominantly Inattentive type (ADHD-I). In case they develop issues of inattention and distractibility as well as hyperactivity and impulsiveness, such a situation is known as ADHD Combined Type (ADHD-C).
In order to be found to have ADHD-I, young individuals are required to exhibit 6 or more of the following symptoms:
- Inability to maintain attention in tasks or play or even making careless mistakes or poor attention to detail at school or extracurricular activities, at work or in other activities.
- He has a trouble maintaining focus on tasks or kinds of play.
- Moreover, he does not seem to be listening to, except when he is personally addressed to.
- Shows failure to follow instructions, complete schoolwork, chores and responsibilities at the work place (e.g., loses focus, is side tracked).
- Uncomfortable when it comes to organising planning activities and tasks.
Is easily distracted
- In the day-to-day tasks, forgetful Is is quite common
To receive a diagnosis as ADHD-C, children/young people must have symptoms of impulsivity/hyperactivity – I will not outline these here as they are not the main concern in this article.
To be diagnosed with ADHD, these symptoms above must have been apparent in children before the age of 12, appear in at least two settings (i.e., not only school), prove to be a significant issue in causing problems to those children, cannot be better described by another disorder, and must occur (much) more often than they do in other children of similar age.
Whether, or not, they become so severe that they can be diagnosed as having a formal disorder, inattention and distractibility can cause young people considerable problems in other domains. There are lines of research to indicate that inattention or rather particularly (along with other issues like hyperactivity) are perhaps a part of the reason including learning difficulties as well as other issues like anxiety, problem behaviours and social issues.
One of the issues many children who struggle in the area of attention and distractibility have is an area called working memory. Our working memory skills are our power to have the relevant information in our mind as we calculate and find the solution to the problem/ problem solving power (remembering keep the sets of numbers in our head as we work through a MATHS question), keep our hands on what we are preparing as we get all of our things together to go out, etc). Not every child/teen with attention issues has difficulties with working memory, but many of them do and this can play a role in causing the problems with the attention.
Attentional (and working memory) difficulties can have a lasting impact into adulthood. In a study in New Zealand, spatial executive-attentional control measured in late childhood was associated with educational attainment, social and occupational attainment 20 years later.
It is worth noting though that many children/young people do improve in this area and often these improvements continue to be seen until early adulthood. Others however do not: a study released in 2018 that tracked 5000 children since childhood have found that 1/3 of children with ADHD symptoms remain so in adulthood. An additional independent study demonstrated that children/teens with challenges centring on difficulties with attention and distractibility over a longer term had increased odds of enduring their specific challenges compared to children/teens with challenges centring on hyperactivity and impulsivity.
What are the difficulties in appreciation in inattention and distractibility?
When you feel that your child/teen is having difficulties in the area of inattention and being distracted then it is only understandable that a health expert should be able to evaluate the child/teen and to determine the degree to which they have a problem in this area and whether their problem is real and actual. Unluckily, this is easier to say than done.
The three methods of assessing inattention and distractibility are. The first one is a clinical Interview in which the professionals health professionals pose a series of questions that relate to problems of attention and distractibility. These are how they occur, how far along they have been in place and how disruptive they have been to functioning.
An effective clinical interview must also seek the input of a variety of individuals, including the child/young person himself or herself, parents/family, and the teacher, among others.
Although a clinical interview can be a powerful piece of information gathering, it is extremely subjective and is as varied as the person you ask it and how they feel about what you are asking. Teachers, parents/caregivers as well as young people themselves, are likely to under-estimate or over-estimate the presence of problems with attention because these people are not always certain about what is normal among kids/teens at the different ages. They also might not be aware as to whether the attention problems should be attributed to actual attention/distractibility difficulties -or other underlying learning or emotional issues.
A second method that can be of more practical use in the measuring of the problems with inattention/distractibility is to employ rating scales. These may be questionnaires (typically combined inattention/distractibility and hyperactivity/impulsivity difficulties) completed by the young people, parents/caregivers and others (e.g., teachers) – e.g. (e.g., SNAP-IV 26 – Teacher & Parent Rating Scale – free online versions available) where children/young people scores can be compared to norms.
Although rating scales eliminate some degree of over and under estimation of problems they should be keenly aware that rating scales also have the problems of bias and expectancy effects. In one study the proportion rated by a group of teachers as having attentional problems was massive 75 percent of young people in their classes. Other findings have revealed that these rating scales can exhibit very small interrater agreement – in other words, the ratings provided on these scales by teachers, young people and parents (and even one parent against another parent) can be vastly different in how they rate current attention problems. Other researchers have discovered that this varies according to which day of the week you invite a parent in (and even their mood at the moment!).
All these issues do not imply that we cannot use rating scales but we should exercise caution in using them.
A third approach of evaluating issues related to attention is to conduct standardised cognitive or neuropsychological screenings of attention. These include computer tasks or pen and paper tasks, which are typically simple but require one to maintain close attention /avoid distractions over a specified duration (e.g. the continuous performance test and test of variable-attention).
Unluckily, other types of learning challenges complicate these tests, in addition to children with inattention/distractibility challenges. There are also some children who just find the tasks in these not terribly difficult – even when their genuine inattention/distractibility challenges are evident in real life – possibly because these tasks are not excessively lengthy and are conducted in a quiet and controlled “test” setting.
In general, thus, unfortunately it cannot be said that the measurement of inattention/distractibility is satisfactorily overcome.
What results in the inattention and distractibility problems?
The difficulties with inattention/ distractibility are likely to have a biologic nature of some sort. Examples are given where studies calculate genetic causes of up to 85% of ADHD (all types). In the past few years, there has been much more recognition of the biological aspect of the problem of attention problems and this has done vast amounts of harm in eradicating stigma, shame and encouraging people to seek help.
But as with most psychological difficulties, it is probably the case that non biological and environment factors play a part in inattention/distractibility problems in the young people. Examples of such factors studied are diet (sugary and energy drinks intake among others), sleep and general health.
Far more convincing are the eleven levels of physical exercise, parenting practices and overall psychological well-being that demonstrate that many factors do affect the level of inattention and distractibility in children and youth.